Karawajczyk Malgorzata, Douhan Håkansson Lena, Lipcsey Miklos, Hultström Michael, Pauksens Karlis, Frithiof Robert, Larsson Anders
Department of Medical Sciences, Clinical Chemistry, Uppsala University, Sjukhusvägen, entr 61, Uppsala, 751 05, Sweden.
Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden.
Ther Adv Infect Dis. 2021 Jul 31;8:20499361211034065. doi: 10.1177/20499361211034065. eCollection 2021 Jan-Dec.
The pronounced neutrophilia observed in patients with coronavirus disease 2019 (COVID-19) infections suggests a role for these leukocytes in the pathology of the disease. Monocyte and neutrophil expression of CD64 and CD11b have been reported as early biomarkers to detect infections. The aim of this study was to study the expression of receptors for IgG (CD64) and adhesion molecules (CD11b, CD15s, CD65, CD162, CD66b) on neutrophils and monocytes in patients with severe COVID-19 after admission to an intensive care unit (ICU).
The expression of receptors was analyzed using flow cytometry. EDTA blood from 23 patients with confirmed COVID-19 infection was sampled within 48 h of admission to the ICU. Leukocytes were labeled with antibodies to CD11b, CD15s, CD65s, CD162, CD64, and CD66b. Expression of receptors was reported as mean fluorescence intensity (MFI) or the percentage of cells expressing receptors.
Results are presented as comparison of COVID-19 patients with the healthy group and the receptor expression as MFI. Neutrophil receptors CD64 (2.5 0.5) and CD66b (44.5 34) were increased and CD15 decreased (21.6 28.3) when CD65 (6.6 4.4), CD162 (21.3 21.1) and CD11b (10.5 12) were in the same range. Monocytes receptors CD64 (30.5 16.6), CD11b (18.7 9.8), and CD162 (38.6 36.5) were increased and CD15 decreased (10.3 17.9); CD65 were in the same range (2.3 1.96).
Monocytes and neutrophils are activated during severe COVID-19 infection as shown by strong upregulation of CD64. High monocyte and neutrophil CD64 can be an indicator of a severe form of COVID19. The adhesion molecules (CD11b, CD162, CD65, and CD15) are not upregulated on otherwise activated neutrophils, which might lead to relative impairment of tissue migration. Low adhesion profile of neutrophils suggests immune dysfunction of neutrophils. Monocytes maintain upregulation of some adhesion molecules (CD11b, CD162) suggesting the persistence of an increased ability to migrate into tissues, even during a severe stage of COVID-19. Future research should focus on CD64 and CD11b kinetics in the context of prognosis.
2019冠状病毒病（COVID-19）感染患者中明显的中性粒细胞增多表明这些白细胞在该疾病的病理过程中发挥作用。据报道，单核细胞和中性粒细胞上CD64和CD11b的表达可作为检测感染的早期生物标志物。本研究的目的是研究重症COVID-19患者入住重症监护病房（ICU）后，中性粒细胞和单核细胞上IgG受体（CD64）和黏附分子（CD11b、CD15s、CD65、CD162、CD66b）的表达情况。
采用流式细胞术分析受体的表达。在23例确诊为COVID-19感染的患者入住ICU后48小时内采集乙二胺四乙酸（EDTA）抗凝血。白细胞用抗CD11b、CD15s、CD65s、CD162、CD64和CD66b抗体标记。受体表达以平均荧光强度（MFI）或表达受体的细胞百分比表示。
结果以COVID-19患者与健康组的比较以及以MFI表示的受体表达呈现。当CD65（6.6±4.4）、CD162（21.3±21.1）和CD11b（10.5±12）处于相同范围时，中性粒细胞受体CD64（2.5±0.5）和CD66b（44.5±34）升高，CD15降低（21.6±28.3）。单核细胞受体CD64（30.5±16.6）、CD11b（18.7±9.8）和CD162（38.6±36.5）升高，CD15降低（10.3±17.9）；CD65处于相同范围（2.3±1.96）。
如CD64的强烈上调所示，重症COVID-19感染期间单核细胞和中性粒细胞被激活。单核细胞和中性粒细胞高表达CD64可能是重症COVID-19的一个指标。在其他方面被激活的中性粒细胞上，黏附分子（CD11b、CD162、CD65和CD15）未上调，这可能导致组织迁移相对受损。中性粒细胞的低黏附特征表明中性粒细胞存在免疫功能障碍。单核细胞维持一些黏附分子（CD11b、CD162）的上调，表明即使在COVID-19的重症阶段，其迁移到组织中的能力仍持续增强。未来的研究应关注预后背景下的CD64和CD11b动力学。
